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Some at-risk groups for flu immunisation are far more likely to receive the vaccine than others, new research reveals.

The analysis of last year's flu campaign, the first ever to scrutinise uptake in different at-risk groups, found patients with diabetes fared far better than those with heart or respiratory disease.

The data, collected from all practices in Wales, showed uptake in under-65s with diabetes was 61 per cent, compared with only 31 per cent for chronic heart disease.

Uptake was only 24 per cent for chronic respiratory disease and 33 per cent for chronic renal disease, delegates at the Health Protection Agency annual conference in Warwick heard last week.

Study leader Dr Brendan Mason, consultant epidemiologist at the National Public Health Service for Wales, said patients with diabetes were generally on registers and had good contact with doctors, whereas other patients might be seen more rarely.

Dr Mason urged GPs to be more systematic about inviting patients for flu immunisation. 'We are working with practices to get the message across and improve uptake. The evidence certainly shows GPs who are proactive and send out invitations do better. It's one of the most effective ways of targeting patients,' he said.

Dr Rubin Minhas, a GP in Gillingham, Kent, and CHD lead for Medway PCT, said the data could reflect increased GP awareness about the importance of preventing infection in patients with diabetes.

'But as far as heart disease goes there is a considerable emphasis on other interventions, which may have overshadowed the benefits of flu vaccination,' he said.

Dr David Baxter, consultant in communicable diseases in Stockport, said the data suggested GPs had been juggling limited amounts of stock. 'If you've got limited supplies you're going to do the over-65s first and then go down the list of priorities because you know you're likely to run out. Patients with mild asthma are going to be low down that list,' he added.

·Influenza vaccination uptake among elderly patients is lower in deprived areas than affluent ones, according to an analysis of the UK general practice research database.